Health effects of Tobacco Smoke Pollution

Tobacco smoke pollution (TSP), also known as, “environmental tobacco smoke (ETS)” or “secondhand smoke (SHS)” is the tobacco smoke that enters the environment as a result of (a) sidestream smoke, that comes directly from the burning tip of the tobacco product without having been exhaled by the smoker and (b) mainstream smoke, that has been exhaled by the smoker.

As tobacco smoke is one of the most potent toxic compounds, tobacco smoke pollution can impact on many health problems, even at low levels of exposure. It is estimated that at least 50,000 deaths are attributable to second hand smoke each year in the United States (California Air Resources Board, [CAR] 2005). The list below contains some of the most common health effects of that have been causally linked to TSP.

Developmental Effects
Low birthweight
Sudden Infant Death Syndrome (SIDS)
Pre-term delivery

Respiratory Effects
Acute lower respiratory tract infections in children (e.g., bronchitis and pneumonia)
Asthma induction and exacerbation in children and adults
Chronic respiratory symptoms in children
Middle ear infections in children

Carcinogenic Effects
Lung cancer
Nasal sinus cancer
Breast cancer in younger, primarily pre-menopausal women

Cardiovascular Effects
Coronary artery disease

With cardiovascular diseases being associated with a very high proportion of overall deaths, factors that increase risk of cardiovascular mortality have a substantial societal impact. TSP results in smoke exposure of about 1% of typical active smoking, but increases cardiovascular risk by 30%. Recent evidence suggests that policy regarding TSP can have substantial effects on cardiovascular events. A study conducted in Helena, Montana found that implementation of a comprehensive local ordinance on clean air was related to a 40% reduction in admissions for acute myocardial infarction, which subsequently rebounded after the ordinance was suspended (Sargent, Shephard, Glantz, 2004). This study demonstrates the potential health benefit of establishing smoke-free environments.

It has been demonstrated that non-smokers have statistically greater risk of lung cancer if their spouses are smokers. Meta-analyses show the increased risk of lung cancer was about 25% greater than expected in women and 35% greater in men if their spouses smoked (National Cancer Institute, 1999).

So what can you do to avoid exposure to Tobacco Smoke Pollution? Firstly, if you live in a state that has yet to implement legislation requiring public places to be smoke-free, then make a point of only going to bars and restaurants that are smoke-free and let the owner know how much you appreciate it. Each state produces a list of smoke-free venues.
Secondly, while you can’t necessarily control every environment, one important environment that you may be able to control is your own home. So make sure that you and your family are not exposed to toxic tobacco smoke pollution at home by making your home a Smoke-Free Home. I’ll talk more about smoke-free homes in my next post.

For an extremely comprehensive report on the effects of Tobacco Smoke Pollution, see the 2006 report launched by Surgeon General Carmona (now a member of the board here at Healthline).

For an interesting report on the effects on heart attack rates when a city in Montana passed smoke-free environment legislation (plus a commentary by CDC) see:
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About the Author

MA, MAppSci, PhD

Dr. Jonathan Foulds is an expert in the field of tobacco addiction.